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Anatomy And Physiology > Acute Health Challenges- The Surgical Experience > Flashcards

Acute Health Challenges- The Surgical Experience Flashcards

1
Q

Define Surgery.

A

the art and science of treating diseases injuries and deformities by operation & instrumentation

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2
Q

Name 3 phases of preoperative period.

A

pre-operative
intra-operative
post operative

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3
Q

Reasons for surgery.

A 
dx
cure
palliation
prevention
exploration
cosmetic
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4
Q

Elective surgery.

A

planned surgery

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5
Q

Emergency surgery.

A

unexpected or urgent

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6
Q

Where are surgeries performed?

A
  • OR with admission
  • Same day admission (ambulatory surgery/outpt) -discharged home after
  • Dr.’s office
  • ER
  • Clinics
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7
Q

5 expected outcomes of surgical intervention.

A
  • Dx
  • Reconstructive
  • Curative
  • Palliative
  • Transplant
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8
Q

Diagnostic surgery.

A

(biopsy) origins of symptoms & extent of disease

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9
Q

Reconstructive surgery.

A

correct disease or improve cosmetic appearance

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10
Q

Curative Surgery.

A

repair or remove disease organ- restore normal function (e.g. amputation, aneurysm)

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11
Q

Palliative Surgery.

A

decrease spread of disease and prolong life- alleviate pain

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12
Q

Transplant Surgery.

A

remove organ replace with functioning one

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13
Q

Preoperative nursing role.

A
  • Co-ordinate client care
  • Ensure pre-operative tests are WNR
  • Varify documents (go through pre op checklist)
  • Report abnormalities
  • Major responsibility is teaching in preparation for OR
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14
Q

Pre-op Surgeon Responsibilities.

A
  • Determine need for surgery: Pre-op assessment, determine surgical setting in collaboration with the client, diagnostic tests that directly correlate with the OR and Dx
  • Consent for surgery
  • Teaches client about outcomes and risk of OR
  • Ensures client safety in OR
  • Post-op management
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15
Q

When does the hx and physical done and by whom?

A

30 days before surgery by family physician

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16
Q

Anesthetist responsibilities.

A
  • consent for anesthesia
  • pre op evaluation (hx, complications from previous anesthesia, medications, OTC, Herbal, advise when to D\C meds prior to OR)
  • select anesthetic agents
  • teacher re: anesthetic medications and side effects and risk factors
  • intubation and extubation
  • monitors throughout OR
17
Q

Nurses responsibilities re: consent for surgery.

A
  • must advocate on the pts behalf if additional info is requested
  • consent must be signed prior to the administration of pre-op medications
18
Q

Who’s responsibility is it to get consent for surgery.

A

the physician

19
Q

Conditions for informed consent.

A
  • adequate disclosure
  • demonstration clear understanding and comprehension of the information being provided
  • consent must be voluntarily
20
Q

Assessment in the preoperative phase- Nursing Hx includes.

A
  • factors that can increase risk or influence outcomes
  • medical hx including family hx of anesthesia problems (malignant hyperthermia, etc)
  • medication allergies, other allergies
  • age related factors
  • social/cultural/spiritual concerns (ex. blood transfusions for Jehovah Witness)
  • psychological status (assess fears)
  • 3rd person help with language/mental status if a needed
21
Q

Components of psychological assessment of the pt before surgery.

A

SITUATIONAL CHANGES
- support system
- personal control, decision making, and independence
- impact of surgery on family and dependents, finance, etc.
- hope and anticipation of positive results
CONCERNS WITH THE UNKNOWN
- identify specific areas and depth of anxiety and fear
- identify expectations of surgery, changes in current health status, & effects on daily living
CONCERNS WITH BODY IMAGE
- current roles or view of self
- perceived or potential changes in role or relationships and their impact on body image
PAST EXPERIENCES
- review previous surgical experiences, hospitalizations and txt (positive or negative)
- current perception of surgery in re: to the above
KNOWLEDGE DEFICIT
- Identify what amount and type of preoperative information this specific pt wants to receive
- assess understanding
- identify accuracy in info

22
Q

Subjective health hx data of pt about to undergo surgery.

A

PAST HEALTH HX
- past surgery? which one? complications?
- family hx of surgical complications?
- past hospitalizations?
- chronic health conditions?
- HTN? Cardiac disease?
- Hx of dyspnea, coughing, hemoptysis, COPD or asthma
CURRENT HEALTH HX
- usual or present height and weight? Recent weight loss or gain?
- present respiratory tract infection?
- do you wear glasses, contact lenses, or hearing aids?\
- Do you smoke? How many packs/day? How many years?
- Alcohol intake?
- problems healing?
- musculoskeletal problems that might affect positioning during surgery or activity level after surgery?
- limitation in mobility o your neck?
- equipment for ambulation?
- pain tolerance? methods used for pain relief?
- anxiety r/t surgery?
- support following discharge?
MEDICATIONS
- prescribed? OTC? herbal?
- allergies, or sensitivities to food or meds?

23
Q

Considerations for the older adult.

A
  • normal aging decreased immune system
  • delayed wound healing
  • decreased ability to withstand stress
  • changes in mental status
  • increased incidence of chronic disease
  • increased cardiac pulmonary complications
24
Q

Medical hx.

A
  • previous admissions/ OR
  • past illnesses
  • reason for surgery
  • complications previous OR
  • prior blood transfusion or reactions
  • objections to getting blood
  • Medications (prescribed, OTC/herbal, ASA stopped 2 weeks prior to OR)
25
Q

Preoperative physical assessment.

A
  • VS
  • CV
  • Respiratory
  • Renal
  • Neurologic (oriented x3)
  • Musculoskeletal
  • Nutritional
  • Psychosocial
  • Results of dx tests
26
Q

Benzodiazepines examples, purpose and effects.

A

Decreased anxiety
Induce sedation
Induce amnesia
ex. midazolam (Versed), diazepam (Valium), lorazepam (Ativan)

27
Q

Narcotics examples, purpose and effects.

A

Relieve discomfort during preoperative procedure, decrease the amount of anaesthetic medication required.
Ex. morphine, meperidine (Demerol), fentanyl (Sublimaze)

28
Q

Histamine H2 receptor antagonist examples, purpose and effects.

A

Increase gastric pH, decreased gastric volume

Ex. cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac)

29
Q

Antiemetics examples, purpose and effects.

A

increase gastric emptying and decrease N&S

Ex. metoclopramide (Reglan), droperidol (Inaspine)

30
Q

Anticholinergics examples, purpose and effects.

A

decrease oral and respiratory secretions, prevent bradycardia
ex. atropine, scopolamine

31
Q

Nursing care on the day of OR.

A
  • VS
  • Hygiene
  • check hair, remove cosmetics, &prosthetics
  • safeguard valuables
  • perform bowel and bladder care
  • perform special procedures and give pre-op meds
32
Q

Review chart before sending it to the OR for the following.

A 
pre-op check list
consent
blood work
other dx tests
allergies
33
Q

Types of anesthesia.

A

General
Local
Conscious sedation (procedural sedation)
Regional (neuroaxial)

34
Q

General anesthesia.

A
  • loss of sensation
  • total unconscious state with tube in trachea
  • IV or inhalation
  • aspiration potential
  • post- throat pain, injury to teeth or mouth
35
Q

Local anesthesia.

A

blocks the initiation and transmission of impulses along the nerve fibres

36
Q

Conscious sedation anesthesia (aka procedural sedation).

A
  • minimal depressed level of consciousness “twilight sleep”

- increased pain threshold and induces amnesia

Anatomy And Physiology (18 decks)

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